%0 Journal Article
%T 导管介入治疗急性肺栓塞的临床疗效观察
%A 王玮
%A 罗福全
%A 张挪富
%A 王敏
%J 华西医学
%P 1403-1405
%D 2010
%X 【】目的观察经皮导管介入治疗急性肺栓塞的疗效。方法选择2003年1月-2009年6月收治的急性肺栓塞患者15例，采用经皮导管吸栓术、碎栓术及溶栓术治疗。溶栓术用局部灌注加即刻静脉注射尿激酶，总量100万U。溶栓后给予低分子肝素7~10d，口服华法林3~6个月。观察临床症状、体征改善情况、并发症、平均肺动脉压（mPAP）与动脉血氧分压（PO2）的变化，以及肺动脉开通情况。结果12例肺动脉完全开通，3例部分开通，显效率89%，有效率100%。mPAP从（41.07±6.97）mmHg降到（21.00±5.66）mmHg，PO2从（46.26±9.30）mmHg升到（79.49±8.04）mmHg，治疗前后差异有统计学意义（P<0.05）。即刻临床症状明显改善，mPAP迅速降低11例。随访3~6个月，疗效持续，未见复发。结论介入治疗急性肺栓塞疗效显著，安全可行，对抢救危重患者、改善临床症状、维持血流动力学稳定有重要作用。？【Abstract】ObjectiveToobservetheclinicalcurativeeffectonacutepulmonaryembolism(PE)viapercutaneouscatheterintervention.MethodsFifteenacutePEpatientsadmittedfromJanuary2003toJune2009weretreatedwithpercutaneouscatheterdrawingofthrombus,thrombectomy,andthrombolysis.Localinfusionandimmediateintra-？venousinjectionofurokinasewith100000000Uintotalwereusedforthrombolysis.Afterwards,thelowmolecularweightheparinwasgivenforseventotendays,andanoralintakeofwarfarinlastsforthreetosixmonths.Observetheclinicalsymptoms,improvementofphysicalsigns,occurrenceofcomplications,changeofmeanpulmonaryarterialpressure(mPAP)andarterialpartialpressureofoxygen(PO2),aswellasthepatencyconditionofpulmonaryartery.ResultsTwelveoffifteerpatientsgainedcompletepatencyofpulmonaryartery,andtheotherthreepatientsgainedpartialpatency,withanobviouseffectivenessrateof89%andaneffectivenessrateof100%.mPAPdecreasedfrom(41.07±6.97)mmHgto(21.00±5.66)mmHg,andPO2elevatedfrom(46.26±9.30)mmHgto(79.49±8.04)mmHg,showingasignificantdifference(P<0.05)beforeandafterthetherapy.Theimmediateclinicalsymptomsexhibitedasignificantimprovement.Thepulmonaryarterypressureof11patientsdroppedrapidly.Duringthreetosixmonths’followup,thetherapeuticeffectspersistedandnorecurrencewasfound.ConclusionTheinterventionaltreatmentofacutePEdemonstratesremarkableeffectiveness,safetyandfeasibility,whichplaysanimportantroleintherescueofcriticalpatients,improvementofclinicalsymptoms,andmaintenanceofhemodynamicstability.
%K 肺栓塞
%K 介入治疗
%K 肺动脉
%K 溶栓术
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201008005